Itchy pets 101 (Part 3: Treatment)

JUL 06, 2009

Treating itchy pets usually comes down to getting the right diagnosis for what ails them. We’ve already established that in parts 1 and 2 of this three-part series on the subject of itchiness (pruritus). Next up, my job is to tell you how we get them comfortable again. 

 

Fleas: Got bugs? Let’s get ‘em. Lots of products are aimed at flea-killing. The most popular veterinary-only products are usually your safest bet. And safe is what it’s all about. These are poisons, after all. So give your vet a chance to weigh in on what’s the safest option for your pet.

 

Mange: So much mange, so little time. But these mites don’t always need strong, mite-killing oral medicine or toxic dips (though more severe cases often do). Sometimes, antibiotics, antifungals, shampoos and topical creams can be more than enough. 

 

Hormonal disorders: These get treated based on the hormonal imbalance––whether it’s a depletion (for which they may receive supplements) or an excess (for which treatment varies and depends on the hormone and/or the organ(s) responsible for producing it). 

 

Superficial bacterial and/or fungal infections: Antibiotics and antifungals to conquer these infections come in a multitude of forms. Pills, sprays, flushes, drops, shampoos, conditioners, creams, wipes, sponge-ons, etc. 

 

Whether it’s the underlying cause or secondary to allergies or other troubles, we almost always treat infections separately. After all, these infections are responsible for much of the itchiness as well. 

 

Allergies: The most common source of itchies, allergies have many possible treatments. The most commonly applied versions are those that interfere with or mitigate the effects of the immune system––usually through drugs. 

 

Corticosteroids (like the ubiquitous prednisone pill or the injectable, long-acting Depo Medrol), cyclosporine (marketed as Atopica) and antihistamines (like Zyrtec, Benadryl and hydroxyzine) are by far the most common approaches. They come as pills, shots, sprays, creams, drops and shampoos––and they all have side effects.

 

Corticosteroids top the list for side effects, which is why we hate using them––unless we have to. They also happen to be among the most effective options. That’s why we try to stick to topical forms that are less likely to affect the whole body, as when we treat “hot spots” and ears, even anal glands. 

 

Cyclosporine is another immune system-dampening drug we often use, most often as a caplet that goes by the name, Atopica. Because its side-effects are less than for corticosteroids, we tend to recommend our clients adopt this safer (though by no means risk-free) approach. 

 

Administered once a day or once every other day, this expensive option is usually too pricey for most of my big dog clients, but often accessibly priced for my littler ones. 

 

Antihistamines are the best well-known and safest of the allergy drug alternatives. They interfere with the histamine molecules that cause the itchiness in the skin. Benadryl, Zyrtec and hydroxyzine are the ones most commonly prescribed. Unfortunately, they happen to be not as effective as the steroids and cyclosporines of this world. 

 

Finally, my favorite choices: Allergy vaccines, supplements and dietary therapy. 

 

Therapeutic, novel protein or hydrolyzed protein diets are often prescribed for these pets. Read up on food trials and how these diets can work here.

 

By far the best studied supplement for pets with any skin disease––but especially itchy skin problems––is the lowly fatty acid. Get one that's specifically formulated for pet skin and you'll be giving all these other methods a real boost...naturally.

 

As to allergy vaccines, here’s another whole post for your review.

 

Any questions? 

 

Dr. Patty Khuly

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12 COMMENTS
1
Home made dog food
by Darryll Green on 07/07/2009 10:27am

where can i find info on how to make homemade dry dog food

2
Home made dog food
by Dolittler on 07/07/2009 03:25pm

It's harder to make dry food than the wet stuff but it's doable with an oven. It'll probably last longer, too. Just follow your same recipe and pop small "meatballs" in a 250 degree oven until they're crispy. For recipes, ask your veterinarian or locate a nutritionist through aavn.org. Good luck!

Dr. Patty Khuly

3
Home made dog food
by Dolittler on 07/07/2009 03:28pm

You should also check out this Daily Vet post:
http://petmd.com/blogs/dailyvet/2009/July/02

4
Not helpful
by Milhouse on 07/16/2009 01:16pm

This was not very helpful. You don't actually address specifically HOW to treat the pets, but provide a litany of possibilities. If I get a rash, I could easily write a blog like this explaining what might be the problem. How do you distinguish between ectoparasitic infestations and allergies, for example. There must be a qualitative difference in the location, intensity, duration, and onset periods for all of these. Please remember that people attempting to mitigate veterinary expenses turn to PetMD.com for help, and should be rewarded with their patronage. Thanks.

5
Not helpful ?
by galadriel on 07/21/2009 11:31am

Milhouse, I presume that if you're not taking a chronically itchy dog to the vet that you have all the equipment at home to culture a sample to see if there's a bacterial or fungal infection? You have all the equipment and supplies to test for and diagnose allergies? You have the microscope and experience to diagnose mange?

Sometimes you can't treat a dog yourself without someone to properly diagnose the underlying cause. Sometimes you genuinely need a vet's help. All the articles in the world can't get around that.

6
Not helpful?
by Dolittler (Dr. Patty Khuly) on 07/21/2009 07:58pm

Thanks, galadriel, for coming to my rescue. It's absolutely impossible to do justice to this topic without detailing all the possibilities and potential outcomes. Millhouse: If I were to offer you a way to treat basic itchies in a general manner, I might well steer you in the exact opposite direction you need to go. For that reason, I choose to take the tack that a basic understanding of the complexity of the subject will arm you with knowledge when you go see your veterinarian. That will not only bring your pets better care, it may well save you money, too. Looking to a resource like PetMD for a quick, money-saving fix doesn't help anyone in the long run. IMHO.

7
Steroids
by sydneysmom on 07/28/2009 07:27pm

I took my large breed dog to the vet today for a itchy smelly ear, which was cultured and came back positive for yeast. A steriod shot followed and pills for home. Since the vet trip my dog has had 3 accidents in the house in the last 10 hours. Is this a side effect from the steriods?

8
Steroids
by Dolittler (Dr. Patty Khuly) on 07/30/2009 05:57pm

Almost certainly, syneysmom. It's typical for anyone on steroids to have an increaed thirst, hence an increased need to urinate--or is it vice versa? ;-)

9
Itchy skin & bladder cancer/infections?
by Indiana'smom on 09/13/2009 12:24pm

My chocolate lab Indiana has been battling alleries/itchy skin for years. When he was about 4 we started by doing food trials, that didn't help. Then allergy testing & allergy shots w/corticolsteroids when needed. It helped for a while, but side effects of steroids were too great, and antigen shots didn't seem as effective anymore. Re-test showed new allergies. so got new antigens. BUt allergy # was never higher then 2 or 3 on aly tests. Still didn't seem, to help. He also has history of blader crystals, infection, & stones. Ever since his prostate was removed, never had reoccurance. Tried more anti-biotics, and didn't help.

Then, last month we finally tried Atopica, and he has now developed bloody urine, and per ultrasound, tissue growth in the bladder, that may or may not be cancerous. Any chance this sudden on-set of bladder cancer/or sever infection/growth could be related to the Atopica? His last bladder ultrasound 8 months ago was clear. He had so many side-effectswith the Atopica, that I will never let him take it again. How can someone perscribe a dog with known chronic infections, immunosuppressive drugs? That just sounds like a disaster waiting to happen. I am mad at myself for even giving them to him.

Any chance thisis not related to teh Atopica, or that the itchy skin and bladder issues are connected, rather then allergies? My poor dog...we just want him to be comfortable and not keep us & him up allnight itching, and now hope that his bladder growth/possible cancer is treatable. :'-(

10
For Syndey'smom
by Indiana'smom on 09/13/2009 12:33pm

My chocolate lab had the same yeast ear issue ever since a pup (he loves to swim.) We've been managin it very well for about 8 years now with the following regimen (instead of cortocsteroids):

1) Once per month, use Oti-Clens ear wash, follwed by flushing with ear bulb syringe & rinse solution
2) Once ears are dry, one squeeze of the tri-otic anti-fungal ear gel in each ear. (We keep it in the fridge, & my dog likes the coolness of the gel.) The gel has like a 1 yr expiration, so you can keep it at home, but it is perscribed by your vet.

Works like a charm! Great inexpensive, no side-effect, once monthly preventative routine for yeasty ears, & my vet now recommeds it to others too. :-)

11
Fleas inside any cavity of a dog?
by Lenna Marler on 09/22/2009 07:00am

I was wondering if fleas can actually crawl inside any of a dogs cavities? Including the eyes, anus,ears and nose. My dog acts like they're inside of him.

12
Mold and Fungus Allergy
by LeroyandRomes on 08/10/2010 10:41pm

Our family has been in and out of the vet for months, for our 70 lbs pit bull. Shampoos, ointments, ear cleansers, steroids, and antibiotics seem to be the regime. All of that helps, until the medication is finished. She has been allergy tested, but levels were not high enough for the vet to recommend a monthly allergy shot. We are trying allergen free foods, fish oil pills, and Benadryl as an at home plan of action. Nothing seems to be helping... I feel like we have done everything short of taking her a dermatologist for dogs.

I read online that we could try different allergy medications (over the counter), and find a better fit by trial and error. I am going to try Claritin (NOT D). Is that safe? What dosage?

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Photo of Patty Khuly

Patty Khuly

VMD, MBA

...is a small animal veterinarian in Miami, Florida, where she practices medicine at Sunset Animal Clinic and serves on the board of the South Florida Veterinary Medical Association. She is a graduate of Wellesley College, the University of Pennsylvania School of Veterinary Medicine, and The Wharton School of Business.

As a significant sideline, she writes...a lot. Apart from her daily blogging here at PetMD's FullyVetted, she authors weekly pet health columns for USA Today and The Miami Herald. She also writes a popular monthly column for Veterinary Practice News and serves as regular contributor to Veterinary Economics, The Bark, and the Veterinary News Network.

Dr. Khuly lives in South Miami with her brood of hens, goats, dogs, cats...and humans.

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